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It is a questionnaire used to determine whether erectile dysfunction is present. This form questions men about sexual dysfunction on five basic issues: the ability to achieve and maintain adequate erections, the level of sexual satisfaction, and to evaluate the effectiveness of a particular treatment. The form aims to provide a reliable reflection of sexual function.

1.) How often did you experience an erection during sexual activity in the last 4 weeks?
2.) What proportion of sexually aroused erections during the last 4 weeks were sufficient to enable sexual intercourse?
3.) How often was penetration possible during sexual intercourse attempts in the last 4 weeks?
4.) How often have you been able to maintain erection during sexual intercourse in the last 4 weeks?
5.) How much difficulty did you have in maintaining an erection to complete sexual intercourse in the last 4 weeks?
6.) How many times have you attempted sexual intercourse in the last 4 weeks?
7.) How often were you satisfied with your sexual intercourse attempts in the last 4 weeks?
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About Erectile Function Testing

Erectile function testing is one of the most common methods used to evaluate sexual dysfunction in men. This assessment is usually done with a questionnaire called the “International Index of Erectile Function” (IIEF). The IIEF was developed by Dr. Raymond Rosen and his team in 1997 and has gained widespread acceptance in the scientific community. The questionnaire helps to identify potential problems by comprehensively evaluating the status of men’s sexual function.

Purpose of this Form

The IIEF questionnaire is designed to objectively measure an individual's status, particularly in critical areas such as erectile function and sexual satisfaction. Questions in the questionnaire provide information to measure a patient's ability to achieve and maintain erection hardness, level of satisfaction with sexual intercourse, and effectiveness of treatment methods.

The survey focuses on five key issues:

1. Adequacy of erection
2. Duration of erection
3. Level of sexual satisfaction
4. Orgasm quality
5. General sexual satisfaction

Classification of Erectile Dysfunction (ED)

The survey's 6 questions (questions 1, 2, 3, 4, 5 and 15) regarding erectile function are used to determine the severity of erectile dysfunction (ED). The answers to these questions are evaluated with a specific scoring system:

• “Not at all or almost not at all”: 1 point
• “Rarely”: 2 points
• “Sometimes”: 3 points
• “Mostly”: 4 points
• “Always”: 5 points

The total score obtained is used to classify the severity of erectile dysfunction:

Erectile Function Score Erectile Dysfunction Classification
6-10 Severe ED
11-16 Medium ED
17-25 Mild ED
26-30 no ED

Importance of Survey Responses

The questions in this survey ask about changes in your sexual life in the last 4 weeks. Answering the questions honestly and clearly will help your doctor determine the most appropriate treatment method for you. Your answers will only be evaluated by your doctor and your confidentiality will be protected.

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